| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,623 |
1,364 |
$147K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,426 |
1,140 |
$113K |
| A0390 |
Als mileage (per mile) |
651 |
500 |
$93K |
| A0425 |
Ground mileage, per statute mile |
3,306 |
2,547 |
$75K |
| S0209 |
Wheelchair van, mileage, per mile |
285 |
232 |
$17K |
| A0380 |
Bls mileage (per mile) |
233 |
171 |
$12K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
308 |
257 |
$12K |
| A0434 |
Specialty care transport (sct) |
30 |
26 |
$8K |
| T2003 |
Non-emergency transportation; encounter/trip |
407 |
270 |
$7K |
| A0398 |
Als routine disposable supplies |
222 |
178 |
$2K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
98 |
88 |
$1K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
18 |
13 |
$801.29 |
| 93042 |
|
13 |
12 |
$0.00 |